Journal ArticleDOI
Prevalence and clinical implications of sarcopenic obesity in patients with solid tumours of the respiratory and gastrointestinal tracts: a population-based study.
Carla M. Prado,Jessica R L Lieffers,Linda J. McCargar,Tony Reiman,Michael B. Sawyer,Lisa Martin,Vickie E. Baracos +6 more
TLDR
Evidence is provided of the great variability of body composition in patients with cancer and links body composition, especially sarcopenic obesity, to clinical implications such as functional status, survival, and potentially, chemotherapy toxicity.Abstract:
Summary Background Emerging evidence on body composition suggests that sarcopenic obesity (obesity with depleted muscle mass) might be predictive of morbidity and mortality in non-malignant disease and also of toxicity to chemotherapy. We aimed to assess the prevalence and clinical implications of sarcopenic obesity in patients with cancer. Methods Between Jan 13, 2004, and Jan 19, 2007, 2115 patients with solid tumours of the respiratory or gastrointestinal tract from a cancer treatment centre serving northern Alberta, Canada, were identified. Available lumbar CT images of the obese patients were analysed for total skeletal muscle cross-sectional area; these values were also used to estimate total body fat-free mass (FFM). Findings Of the 2115 patients initially identified, 325 (15%) were classified as obese (body-mass index [BMI] ≥30). Of these obese patients, 250 had CT images that met the criteria for analysis. The remaining 75 patients were recorded as without assessable scans. Obese patients had a wide range of muscle mass. Sex-specific cut-offs that defined a significant association between low muscle mass with mortality were ascertained by optimum stratification analysis: 38 (15%) of 250 patients who had assessable CT images that met the criteria for analysis were below these cut-offs and were classified as having sarcopenia. Sarcopenic obesity was associated with poorer functional status compared with obese patients who did not have sarcopenia (p=0·009), and was an independent predictor of survival (hazard ratio [HR] 4·2 [95% CI 2·4–7·2], p r 2 =0·37). Assuming that FFM represents the volume of distribution of many cytotoxic chemotherapy drugs, we estimated that individual variation in FFM could account for up to three-times variation in effective volume of distribution for chemotherapy administered per unit body-surface area, in this population. Interpretation This study provides evidence of the great variability of body composition in patients with cancer and links body composition, especially sarcopenic obesity, to clinical implications such as functional status, survival, and potentially, chemotherapy toxicity. Funding Canadian Institutes of Health Research (Ottawa, ON, Canada), Alberta Cancer Board (Edmonton, AB, Canada), and Translational Research Training in Cancer (Edmonton, AB, Canada).read more
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Sarcopenia: European consensus on definition and diagnosis Report of the European Working Group on Sarcopenia in Older People
Alfonso J. Cruz-Jentoft,Jean-Pierre Baeyens,Jürgen M. Bauer,Yves Boirie,Tommy Cederholm,Francesco Landi,Finbarr C. Martin,Jean-Pierre Michel,Yves Rolland,Stéphane M. Schneider,Eva Topinkova,Maurits Vandewoude,Mauro Zamboni +12 more
TL;DR: The European Working Group on Sarcopenia in Older People (EWGSOP) developed a practical clinical definition and consensus diagnostic criteria for age-related sarcopenia as discussed by the authors.
Journal ArticleDOI
Definition and classification of cancer cachexia: an international consensus
Kenneth C. H. Fearon,Florian Strasser,Stefan D. Anker,Ingvar Bosaeus,Eduardo Bruera,Robin L. Fainsinger,Aminah Jatoi,Charles L. Loprinzi,Neil MacDonald,Giovanni Mantovani,Mellar P. Davis,Maurizio Muscaritoli,Faith D. Ottery,Lukas Radbruch,Paula Ravasco,Declan Walsh,Andrew Wilcock,Stein Kaasa,Vickie E. Baracos +18 more
TL;DR: A framework exists on a framework for the definition and classification of cancer cachexia, a multifactorial syndrome defined by an ongoing loss of skeletal muscle mass that cannot be fully reversed by conventional nutritional support and leads to progressive functional impairment.
Journal ArticleDOI
Cancer cachexia in the age of obesity: skeletal muscle depletion is a powerful prognostic factor, independent of body mass index.
Lisa Martin,Laura Birdsell,Neil MacDonald,Tony Reiman,M. Thomas Clandinin,Linda J. McCargar,Rachel A. Murphy,Sunita Ghosh,Michael B. Sawyer,Vickie E. Baracos +9 more
TL;DR: Patients with cancer who are cachexic by the conventional criterion and by two additional criteria (muscle depletion and low muscle attenuation) share a poor prognosis, regardless of overall body weight.
Journal ArticleDOI
A practical and precise approach to quantification of body composition in cancer patients using computed tomography images acquired during routine care
Marina MourtzakisM. Mourtzakis,Carla M. Prado,Jessica R. Lieffers,Tony Reiman,Linda J. McCargar,Vickie E. Baracos +5 more
TL;DR: DXA-based analysis of fat and fat-free mass was performed in 50 cancer patients and compared with bioelectrical impedance analysis (BIA) and with regional computed tomography (CT) images available in the patients' medical records, finding CT presents great practical significance due to the prevalence of these images in patient diagnosis and follow-up.
Journal ArticleDOI
Consensus definition of sarcopenia, cachexia and pre-cachexia: joint document elaborated by Special Interest Groups (SIG) "cachexia-anorexia in chronic wasting diseases" and "nutrition in geriatrics"
Maurizio Muscaritoli,Stefan D. Anker,Josep M. Argilés,Zaira Aversa,Juergen M. Bauer,Gianni Biolo,Yves Boirie,Ingvar Bosaeus,Tommy Cederholm,Paola Costelli,Kenneth C. H. Fearon,Alessandro Laviano,Marcello Maggio,F. Rossi Fanelli,Stéphane M. Schneider,Annemie M. W. J. Schols,Cornel C. Sieber +16 more
TL;DR: The definition of cachexia, pre-cachexia and sarc Openia as well as the criteria for the differentiation between cachexia and other conditions associated with sarcopenia, which have been developed in cooperation with the ESPEN SIG on nutrition in geriatrics are reported.
References
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Cadaver validation of skeletal muscle measurement by magnetic resonance imaging and computerized tomography
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